Case 5.15 Query Analysis (20 points)
Review the following Queries and determine if they are acceptable physician queries. Give the reason for your decision for each case.
3. Patient name: Tim Smith MRN: 1074567 Dates of service: 09/27/2016 - 09/30/2016
Dr. John Day
Please add pneumonia as indicated in the CXR.
Coder: Doe
4. Patient name: Margaret Brown MRN: 10897432 Dates of service: 09/27/2016 - 09/30/2016
Dr. Elizabeth Moore
If you will document the BBB in the progress notes we can increase reimbursement.
Coder: Peter
Please provide accurate answers and detailed rationale for each answer. Thank you ( :
In the case of Tim Smith, the query was to add pneumonia in the diagnosis, and they were expressing the concern that it was explained in the x ray. So, if there is an indication of pneumonia can be seen in the chest x ray then it has to be added in the diagnosis and it has to be managed in that direction. So, a positive response can be given that query.
In the case of Margaret Brow, they are asking to add BBB in the progress note to increase the reimbursement, it can be considered completely unethical. If the patient doesn’t have a diagnosis of BBB how it can be possible to add the same. If there is a clear evidence in the investigation and manifestation of the patient having BBB then it can be added, not for any reimbursement purpose.
Case 5.15 Query Analysis (20 points) Review the following Queries and determine if they are acceptable...
Case 5.15 Query Analysis (20 points) Review the following Queries and determine if they are acceptable physician queries. Give the reason for your decision for each case. 1. Dr. Hightower Mrs. Smith was admitted on 8/25, and two days later you mention in a progress note a stage three pressure ulcer of her heel that you debrided at the bedside. Can you clarify was the stage three heel pressure ulcer present on admission?_____Yes_____NO C. Coder 9/2 Ext. 2112 2. Patient...
Case 5.15 Query Analysis (20 points) Review the following Queries and determine if they are acceptable physician queries. Give the reason for your decision for each case. 1. Dr. Hightower Mrs. Smith was admitted on 8/25, and two days later you mention in a progress note a stage three pressure ulcer of her heel that you debrided at the bedside. Can you clarify was the stage three heel pressure ulcer present on admission?_____Yes_____No C. Coder 9/2 Ext. 2112 2. Patient...
Case 5-8 Physician Query Policy You have suspected there are problems in the physician query process for a while now, and you have planned to review the policy and query form to look for any compliance issues. You would rather find the problems yourself before the Office of the Inspector General (OIG) finds them. Your task today is to evaluate the physician query process at your facility. Figures 5-1 and 5-2. Evaluate Figure 5-1 on all aspects including the following:...
CLINICAL CLASSIFICATION SYSTEMS AND REIMBURSEMENT METHODS CASE 2-12 . Physician Query Polity You have suspected there are problems in the physician query process for a while now, and you have planned to review the policy and query form to look for any compliance issues. You would rather find theproblem s yourself before the Office of the Inspect r General (OIG) İ ds iheim Yor task toda, is to evaluate the physician query process at your facility 1. Review Figures 2-1...
Write MySQL query statements for the questions below including the output that proves the accuracy of your solution. Your answers should be stored in a text file that captures your interaction with MySQL. 1. Find the movieID, title, year and DVDPrice of all movies where the DVD-Price is equal to the discountPrice. 2. Find the actorID, lastName, firstName, middleName, and suffix of all actors whose middleName is not NULL. 3. Suppose you remember a movie quote as “Play it again,...